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BAŞ AĞRILI BİREYLERDE SERVİKAL KAS İSKELET SİSTEMİ BOZUKLUKLARI

Year 2021, Volume: 6 Issue: 2, 42 - 52, 31.07.2021

Hülya Altmış Arzu Güçlü Gündüz

https://doi.org/10.52881/gsbdergi.873465

Abstract

Baş ağrısı, bireysel ve sosyo-ekonomik etkileri oldukça fazla, birçok etkene bağlı, sık karşılaşılan genel bir sağlık problemidir. Sık görülen baş ağrısı tipleri gerilim tipi baş ağrısı (GBA), migren ve servikojenik baş ağrısıdır (SBA). Son yıllarda, boyun ağrısının baş ağrılarındaki rolüne yönelik ilgi ve araştırmaların arttığı görülmektedir. Bu derleme GBA, migren ve SBA’ da servikal kas iskelet sistemi bozukluklarını incelemek amacıyla yapılmıştır.
GBA, servikal kas iskelet sistemi fonksiyonları ile en ilişkili baş ağrısı gibi görünmektedir. Bu baş ağrısı tipinde görülen en sık servikal kas iskelet sistemi bozuklukları; aşırılaşmış baş anterior tilti, azalmış servikal mobilite, artmış tetik nokta sayısı ve kas hassasiyeti ile düşük basınç ağrı eşiğidir. GBA’ da kas fonksiyon yetersizliği çalışma sonuçları ise çelişkilidir.
Migren, patofizyolojik açıdan servikal kas iskelet sistemi bozukluklarıyla daha uzak bir ilişki göstermektedir. Migrende görülen servikal kas iskelet sistemi bozukluklarında; azalmış servikal mobilite, artmış tetik nokta sayısı ve basınç ağrı eşiği sonuçları daha belirgin iken, aşırılaşmış baş anterior tilti ve kas fonksiyon yetersizliği sonuçları çelişkilidir.
SBA ise servikal omurga ile en ilişkili baş ağrısı alt grubu olmasına karşın, servikal kas iskelet sistemi bozuklukları sonuçları çelişkili ve konuyla ilgili güncel veriler yetersizdir. SBA’ lı hastalarda azalmış servikal mobilite ve yetersiz kas fonksiyonu sonuçları daha belirginken, aşırılaşmış baş anterior tilti sonuçlarının çelişkili olduğu görülmektedir.
Sonuç olarak; GBA, migren ve SBA servikal kas iskelet sistemi bozuklukları ile ilişkili görünmektedir. Baş ağrısı tedavisinde, servikal bölgeyi incelemek ve bu bölgede fiziksel performansı geliştirecek egzersiz yaklaşımlarını önermenin önemli olduğunu düşünmekteyiz.

Keywords

Baş ağrısı servikal bölge kas iskelet sistemi bozuklukları

References

  • 1. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition International Headache Society 2018. Cephalalgia. 2018; 38(1): 1–211.
  • 2. Luciano MO, Da Silva Gauto YO, De Santana Neto FJ, Da Silva MG, Germano-Soares AH, Diniz PRB. Effects of Different Exercise Intensities on Headache A Systematic Review. Am J Phys Med Rehabil. 2020; 99: 390–396.
  • 3. Fernández-de-las-Peñas C, Florencio LL, Plaza-Manzano G, Arias-Buría JL. Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: Narrative Literature Review. Int J Environ Res Public Health. 2020; 17(4126): 1-17.
  • 4. Rubio-Ochoa J, Benítez-Martínez J, Lluch E, Santacruz-Zaragoz S, Gomez-Contreras P, Cook CE. Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review. Man Ther. 2016; 21: 35-40.
  • 5. Mitsikostas DD, Ashina M, Craven A, Diener HC, Goadsby PJ, Ferrari MD, Lamp C, Paemeleire K, Pascual J, Siva A, Olesen J, Osipova V ve Martelletti P. European headache federation consensus on technical investigation for primary headache disorders. J Headache Pain. 2016; 17(5): 1-8.
  • 6. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012; 15,380(9859): 2163-96.
  • 7. Howard PD, Behrns W, DiMartino M, DiMambro A, McIntyre K, Shurer C. Manual examination in the diagnosis of cervicogenic headache: a systematic literature review. J Man Manip Ther. 2015; 23(4): 210-218.
  • 8. Luedtke K, Boissonnault W, Caspersen N, Castien R, Chaibi A, Falla D, et al. International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study. Man Ther. 2016; 23: 17-24.
  • 9. Jull G, Hall T. Cervical musculoskeletal dysfunction in headache: How should it be defined? Musculoskelet Sci Pract. 2018; 38: 148-150.
  • 10. Castien R, De Hertogh W. A Neuroscience Perspective of Physical Treatment of Headache and Neck Pain. Front Neurol. 2019; 10: 276.
  • 11. Carvalhoa GF, Schwarzc A, Szikszaya TM, Adamczyka WM, Bevilaqua-Grossic D, Luedtke K. Physical therapy and migraine: musculoskeletal andbalance dysfunctions and their relevance for clinical practice. Braz J Phys Ther. 2020; 24(4): 306-17.
  • 12. Florencio LL, Giantomassi MCM, Carvalho GF, Goncalves MC, Dach F, Fernandez-de-las-Penas C, et al. Generalized Pressure Pain Hypersensitivity in the Cervical Muscles in Women with Migraine. Pain Med. 2015; 16: 1629-1634.
  • 13. Liang Z, Galea O, Thomas L, Jull G, Treleaven J. Cervical musculoskeletal impairments in migraine and tension type headache: A systematic review and meta-analysis. Musculoskelet Sci Pract. 2019; 42: 67-83.
  • 14. Bogduk N. The neck and headaches. Neurol Clin. 2014; 32: 471-487.
  • 15. Bartsch T. Migraine and the neck: new insights from basic data. Curr Sci. 2005; 9: 191-196.
  • 16. Ferna´ndez-de-las-Penas C, Ferna´ndez-Mayoralas DM, Ortega-Santiago R, Ambite-Quesada S, Palacios-Cena D, Pareja JA. Referred pain from myofascial trigger points in head and neck–shoulder muscles reproduces head pain features in children with chronic tension type headache. J Headache Pain. 2011; 12: 35-43.
  • 17. Lidegaard M, Andersen LL. Association Between Trapezius Muscle Tenderness and Tension-Type Headache in Female Office Workers: A Cross-sectional Study. J Manipulative Physiol Ther. 2018; 41: 483-487.
  • 18. Ferna´ndez-de-las-Penas C, Cuadrado ML. Physical therapy for headaches. Cephalalgia. 2016; 36(12): 1134-1142.
  • 19. Abboud J, Marchand AA, Sorra K, Descarreaux M. Musculoskeletal physical outcome measures in individuals with tension-type headache: A scoping review. Cephalalgia. 2013; 33(16): 1319-1336.
  • 20. Ferna´ndez-de-Las-Penas C, Cuadrado ML, Pareja JA. Myofascial trigger points, neck mobility, and forward head posture in episodic tension-type headache. Headache. 2007; 47: 662-672.
  • 21. Edvinsson JCA, Viganò A, Alekseeva A, Alieva E, Arruda R, De Luca C, et al. The fifth cranial nerve in headaches. J Headache Pain. 2020; 21: 65.
  • 22. Rohmann JL, Rist PM, Buring JE, Kurth T. Migraine, headache, and mortality in women: a cohort study. J Headache Pain. 2020; 21: 27.
  • 23. Lemmens J, De Pauw J, Van Soom T, Michiels S, Versijpt J, Van Breda E, et al. The effect of aerobic exercise on the number of migraine days, duration and pain intensity in migraine: a systematic literature review and meta-analysis. J Headache Pain. 2019; 20: 16.
  • 24. Côté P, Yu H, Shearer HM, Randhawa K, Wong JJ, Mior S, et al. Non-pharmacological management of persistent headaches associated with neck pain: a clinical practice guideline from the Ontario protocol for traffic Injury management (OPTIMa) collaboration. Eur J Pain. 2019; 23: 1051-1070.
  • 25. Ferracini GN, Chaves TC, Dach F, Bevilaqua-Grossi D, Ferna´ndez-de-las-Penas C, Speciali JG. Relationship Between Active Trigger Points and Head/Neck Posture in Patients with Migraine. Am J Phys Med Rehabil. 2016; 95(11): 831-839.
  • 26. Fernández-de-las-Peñas C, Cuadrado ML, Pareja JA. Myofascial trigger points, neck mobility and forward head posture in unilateral migraine. Cephalalgia. 2006; 26: 1061-1070.
  • 27. Bragatto MM, Bevilaqua-Grossi D, Benatto MT, Lodovichi SS, Pinheiro CF, Carvalho GF, et al. Is the presence of neck pain associated with more severe clinical presentation in patients with migraine? A cross-sectional study. Cephalalgia. 2019; 39(12): 1500-1508.
  • 28. Luedtke K, Starke W, May A. Musculoskeletal dysfunction in migraine patients. Cephalalgia. 2018; 38(5): 865-875.
  • 29. Horwitz S, Stewart A. An Exploratory Study to Determine the Relationship between Cervical Dysfunction and Perimenstrual Migraines. Physiother Can. 2015; 67(1): 30-38.
  • 30. Benatto MT, Florencio LL, Bragatto MM, Lodovichi SS, Dach F, Bevilaqua‑Grossi D. Extensor/flexor ratio of neck muscle strength and electromyographic activity of individuals with migraine: a cross‑sectional study. Eur Spine J. 2019; 28: 2311-2318.
  • 31. Florencio LL, Oliveira AS, Carvalho GF, Tolentino GA, Dach F, Bigal ME, et al. Cervical Muscle Strength and Muscle Coactivation During Isometric Contractions in Patients With Migraine: A Cross-Sectional Study. Headache. 2015; 55: 1312-1322.
  • 32. Abaspour O, Akbari M, Rezasoltani A, Ahmadi A. Relationship between thickness of deep neck muscles synergy and painful side in patients with cervicogenic headache. Cranio. 2019. doi: 10.1080/08869634.2019.1665872.
  • 33. Antonaci F, Inan LE. Headache and neck. Cephalalgia. 2020; 0(0): 1-5.
  • 34. Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther. 2006; 11: 118-129.
  • 35. Farmer PK, Snodgrass SJ, Buxton AJ, Rivett DA. An investigation of cervical spinal posture in cervicogenic headache. Phys Ther. 2015; 95: 212-222.
  • 36. Dumas J-P, Arsenault AB, Boudreau G, Magnoux E, Lepage Y, Bellavance A, et al. Physical impairments in cervicogenic headache: traumatic vs. nontraumatic onset. Cephalalgia. 2001; 21: 884-893.
  • 37. Jull G, Amiri M, Bullock-Saxton J, Darnell R, Lander C. Cervical musculoskeletal impairment in frequent intermittent headache, part 1: subjects with single headaches. Cephalalgia. 2007; 27: 793–802.
  • 38. Snodgrass SJ, Cleland JA, Haskins R, Rivett DA. The clinical utility of cervical range of motion in diagnosis, prognosis, and evaluating the effects of manipulation :a systematic review. Physiotherapy. 2014; 100: 290-304.
  • 39. Uthaikhup S, Sterling M, Jull G. Cervical musculoskeletal impairment is common in elders with headache. Man Ther. 2009; 14: 636-641.
  • 40. Hall T, Robinson K. The flexion-rotation test and active cervical mobility-a comparative measurement study in cervicogenic headache. Man Ther. 2004; 9: 197-202.
  • 41. Mingels S, Granitzer M. Habitual Cervical Posture in Women With Episodic Cervicogenic Headache Versus Asymptomatic Controls. J Manipulative Physiol Ther. 2020; 43: 171-178.
  • 42. Makofsky HW, Douris P, Goldstein LB, Discepolo A, Grion K, Kushnir G, et al. The Effect of the PostureJac on Deep Cervical Flexor Endurance: Implications in the Management of Cervicogenic Headache and Mechanical Neck Pain. Cranio. 2012; 30(1) :187-193.
  • 43. Abaspour O, Javanshir K, Amiri M, Karimlou M. Relationship between cross sectional area of Longus Colli muscle and pain laterality in patients with cervicogenic headache. J Back Musculoskelet Rehabil. 2015; 28(2): 393-399.
  • 44. Uthaikhup S, Assapun J, Kothan S, Watcharasaksilp K, Elliott JM. Structural changes of the cervical muscles in elder women with cervicogenic headache. Musculoskelet Sci Pract. 2017; 29: 1-6.

Year 2021, Volume: 6 Issue: 2, 42 - 52, 31.07.2021

Hülya Altmış Arzu Güçlü Gündüz

https://doi.org/10.52881/gsbdergi.873465

Abstract

References

  • 1. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition International Headache Society 2018. Cephalalgia. 2018; 38(1): 1–211.
  • 2. Luciano MO, Da Silva Gauto YO, De Santana Neto FJ, Da Silva MG, Germano-Soares AH, Diniz PRB. Effects of Different Exercise Intensities on Headache A Systematic Review. Am J Phys Med Rehabil. 2020; 99: 390–396.
  • 3. Fernández-de-las-Peñas C, Florencio LL, Plaza-Manzano G, Arias-Buría JL. Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: Narrative Literature Review. Int J Environ Res Public Health. 2020; 17(4126): 1-17.
  • 4. Rubio-Ochoa J, Benítez-Martínez J, Lluch E, Santacruz-Zaragoz S, Gomez-Contreras P, Cook CE. Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review. Man Ther. 2016; 21: 35-40.
  • 5. Mitsikostas DD, Ashina M, Craven A, Diener HC, Goadsby PJ, Ferrari MD, Lamp C, Paemeleire K, Pascual J, Siva A, Olesen J, Osipova V ve Martelletti P. European headache federation consensus on technical investigation for primary headache disorders. J Headache Pain. 2016; 17(5): 1-8.
  • 6. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012; 15,380(9859): 2163-96.
  • 7. Howard PD, Behrns W, DiMartino M, DiMambro A, McIntyre K, Shurer C. Manual examination in the diagnosis of cervicogenic headache: a systematic literature review. J Man Manip Ther. 2015; 23(4): 210-218.
  • 8. Luedtke K, Boissonnault W, Caspersen N, Castien R, Chaibi A, Falla D, et al. International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study. Man Ther. 2016; 23: 17-24.
  • 9. Jull G, Hall T. Cervical musculoskeletal dysfunction in headache: How should it be defined? Musculoskelet Sci Pract. 2018; 38: 148-150.
  • 10. Castien R, De Hertogh W. A Neuroscience Perspective of Physical Treatment of Headache and Neck Pain. Front Neurol. 2019; 10: 276.
  • 11. Carvalhoa GF, Schwarzc A, Szikszaya TM, Adamczyka WM, Bevilaqua-Grossic D, Luedtke K. Physical therapy and migraine: musculoskeletal andbalance dysfunctions and their relevance for clinical practice. Braz J Phys Ther. 2020; 24(4): 306-17.
  • 12. Florencio LL, Giantomassi MCM, Carvalho GF, Goncalves MC, Dach F, Fernandez-de-las-Penas C, et al. Generalized Pressure Pain Hypersensitivity in the Cervical Muscles in Women with Migraine. Pain Med. 2015; 16: 1629-1634.
  • 13. Liang Z, Galea O, Thomas L, Jull G, Treleaven J. Cervical musculoskeletal impairments in migraine and tension type headache: A systematic review and meta-analysis. Musculoskelet Sci Pract. 2019; 42: 67-83.
  • 14. Bogduk N. The neck and headaches. Neurol Clin. 2014; 32: 471-487.
  • 15. Bartsch T. Migraine and the neck: new insights from basic data. Curr Sci. 2005; 9: 191-196.
  • 16. Ferna´ndez-de-las-Penas C, Ferna´ndez-Mayoralas DM, Ortega-Santiago R, Ambite-Quesada S, Palacios-Cena D, Pareja JA. Referred pain from myofascial trigger points in head and neck–shoulder muscles reproduces head pain features in children with chronic tension type headache. J Headache Pain. 2011; 12: 35-43.
  • 17. Lidegaard M, Andersen LL. Association Between Trapezius Muscle Tenderness and Tension-Type Headache in Female Office Workers: A Cross-sectional Study. J Manipulative Physiol Ther. 2018; 41: 483-487.
  • 18. Ferna´ndez-de-las-Penas C, Cuadrado ML. Physical therapy for headaches. Cephalalgia. 2016; 36(12): 1134-1142.
  • 19. Abboud J, Marchand AA, Sorra K, Descarreaux M. Musculoskeletal physical outcome measures in individuals with tension-type headache: A scoping review. Cephalalgia. 2013; 33(16): 1319-1336.
  • 20. Ferna´ndez-de-Las-Penas C, Cuadrado ML, Pareja JA. Myofascial trigger points, neck mobility, and forward head posture in episodic tension-type headache. Headache. 2007; 47: 662-672.
  • 21. Edvinsson JCA, Viganò A, Alekseeva A, Alieva E, Arruda R, De Luca C, et al. The fifth cranial nerve in headaches. J Headache Pain. 2020; 21: 65.
  • 22. Rohmann JL, Rist PM, Buring JE, Kurth T. Migraine, headache, and mortality in women: a cohort study. J Headache Pain. 2020; 21: 27.
  • 23. Lemmens J, De Pauw J, Van Soom T, Michiels S, Versijpt J, Van Breda E, et al. The effect of aerobic exercise on the number of migraine days, duration and pain intensity in migraine: a systematic literature review and meta-analysis. J Headache Pain. 2019; 20: 16.
  • 24. Côté P, Yu H, Shearer HM, Randhawa K, Wong JJ, Mior S, et al. Non-pharmacological management of persistent headaches associated with neck pain: a clinical practice guideline from the Ontario protocol for traffic Injury management (OPTIMa) collaboration. Eur J Pain. 2019; 23: 1051-1070.
  • 25. Ferracini GN, Chaves TC, Dach F, Bevilaqua-Grossi D, Ferna´ndez-de-las-Penas C, Speciali JG. Relationship Between Active Trigger Points and Head/Neck Posture in Patients with Migraine. Am J Phys Med Rehabil. 2016; 95(11): 831-839.
  • 26. Fernández-de-las-Peñas C, Cuadrado ML, Pareja JA. Myofascial trigger points, neck mobility and forward head posture in unilateral migraine. Cephalalgia. 2006; 26: 1061-1070.
  • 27. Bragatto MM, Bevilaqua-Grossi D, Benatto MT, Lodovichi SS, Pinheiro CF, Carvalho GF, et al. Is the presence of neck pain associated with more severe clinical presentation in patients with migraine? A cross-sectional study. Cephalalgia. 2019; 39(12): 1500-1508.
  • 28. Luedtke K, Starke W, May A. Musculoskeletal dysfunction in migraine patients. Cephalalgia. 2018; 38(5): 865-875.
  • 29. Horwitz S, Stewart A. An Exploratory Study to Determine the Relationship between Cervical Dysfunction and Perimenstrual Migraines. Physiother Can. 2015; 67(1): 30-38.
  • 30. Benatto MT, Florencio LL, Bragatto MM, Lodovichi SS, Dach F, Bevilaqua‑Grossi D. Extensor/flexor ratio of neck muscle strength and electromyographic activity of individuals with migraine: a cross‑sectional study. Eur Spine J. 2019; 28: 2311-2318.
  • 31. Florencio LL, Oliveira AS, Carvalho GF, Tolentino GA, Dach F, Bigal ME, et al. Cervical Muscle Strength and Muscle Coactivation During Isometric Contractions in Patients With Migraine: A Cross-Sectional Study. Headache. 2015; 55: 1312-1322.
  • 32. Abaspour O, Akbari M, Rezasoltani A, Ahmadi A. Relationship between thickness of deep neck muscles synergy and painful side in patients with cervicogenic headache. Cranio. 2019. doi: 10.1080/08869634.2019.1665872.
  • 33. Antonaci F, Inan LE. Headache and neck. Cephalalgia. 2020; 0(0): 1-5.
  • 34. Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther. 2006; 11: 118-129.
  • 35. Farmer PK, Snodgrass SJ, Buxton AJ, Rivett DA. An investigation of cervical spinal posture in cervicogenic headache. Phys Ther. 2015; 95: 212-222.
  • 36. Dumas J-P, Arsenault AB, Boudreau G, Magnoux E, Lepage Y, Bellavance A, et al. Physical impairments in cervicogenic headache: traumatic vs. nontraumatic onset. Cephalalgia. 2001; 21: 884-893.
  • 37. Jull G, Amiri M, Bullock-Saxton J, Darnell R, Lander C. Cervical musculoskeletal impairment in frequent intermittent headache, part 1: subjects with single headaches. Cephalalgia. 2007; 27: 793–802.
  • 38. Snodgrass SJ, Cleland JA, Haskins R, Rivett DA. The clinical utility of cervical range of motion in diagnosis, prognosis, and evaluating the effects of manipulation :a systematic review. Physiotherapy. 2014; 100: 290-304.
  • 39. Uthaikhup S, Sterling M, Jull G. Cervical musculoskeletal impairment is common in elders with headache. Man Ther. 2009; 14: 636-641.
  • 40. Hall T, Robinson K. The flexion-rotation test and active cervical mobility-a comparative measurement study in cervicogenic headache. Man Ther. 2004; 9: 197-202.
  • 41. Mingels S, Granitzer M. Habitual Cervical Posture in Women With Episodic Cervicogenic Headache Versus Asymptomatic Controls. J Manipulative Physiol Ther. 2020; 43: 171-178.
  • 42. Makofsky HW, Douris P, Goldstein LB, Discepolo A, Grion K, Kushnir G, et al. The Effect of the PostureJac on Deep Cervical Flexor Endurance: Implications in the Management of Cervicogenic Headache and Mechanical Neck Pain. Cranio. 2012; 30(1) :187-193.
  • 43. Abaspour O, Javanshir K, Amiri M, Karimlou M. Relationship between cross sectional area of Longus Colli muscle and pain laterality in patients with cervicogenic headache. J Back Musculoskelet Rehabil. 2015; 28(2): 393-399.
  • 44. Uthaikhup S, Assapun J, Kothan S, Watcharasaksilp K, Elliott JM. Structural changes of the cervical muscles in elder women with cervicogenic headache. Musculoskelet Sci Pract. 2017; 29: 1-6.
There are 44 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Makaleler
Authors

Hülya Altmış

Arzu Güçlü Gündüz

Publication Date July 31, 2021
Submission Date February 5, 2021
Acceptance Date April 3, 2021
Published in Issue Year 2021 Volume: 6 Issue: 2

Cite

APA Altmış, H., & Güçlü Gündüz, A. (2021). BAŞ AĞRILI BİREYLERDE SERVİKAL KAS İSKELET SİSTEMİ BOZUKLUKLARI. Gazi Sağlık Bilimleri Dergisi, 6(2), 42-52. https://doi.org/10.52881/gsbdergi.873465
AMA Altmış H, Güçlü Gündüz A. BAŞ AĞRILI BİREYLERDE SERVİKAL KAS İSKELET SİSTEMİ BOZUKLUKLARI. Gazi sağlık bilim. derg. July 2021;6(2):42-52. doi:10.52881/gsbdergi.873465
Chicago Altmış, Hülya, and Arzu Güçlü Gündüz. “BAŞ AĞRILI BİREYLERDE SERVİKAL KAS İSKELET SİSTEMİ BOZUKLUKLARI”. Gazi Sağlık Bilimleri Dergisi 6, no. 2 (July 2021): 42-52. https://doi.org/10.52881/gsbdergi.873465.
EndNote Altmış H, Güçlü Gündüz A (July 1, 2021) BAŞ AĞRILI BİREYLERDE SERVİKAL KAS İSKELET SİSTEMİ BOZUKLUKLARI. Gazi Sağlık Bilimleri Dergisi 6 2 42–52.
IEEE H. Altmış and A. Güçlü Gündüz, “BAŞ AĞRILI BİREYLERDE SERVİKAL KAS İSKELET SİSTEMİ BOZUKLUKLARI”, Gazi sağlık bilim. derg, vol. 6, no. 2, pp. 42–52, 2021, doi: 10.52881/gsbdergi.873465.
ISNAD Altmış, Hülya - Güçlü Gündüz, Arzu. “BAŞ AĞRILI BİREYLERDE SERVİKAL KAS İSKELET SİSTEMİ BOZUKLUKLARI”. Gazi Sağlık Bilimleri Dergisi 6/2 (July 2021), 42-52. https://doi.org/10.52881/gsbdergi.873465.
JAMA Altmış H, Güçlü Gündüz A. BAŞ AĞRILI BİREYLERDE SERVİKAL KAS İSKELET SİSTEMİ BOZUKLUKLARI. Gazi sağlık bilim. derg. 2021;6:42–52.
MLA Altmış, Hülya and Arzu Güçlü Gündüz. “BAŞ AĞRILI BİREYLERDE SERVİKAL KAS İSKELET SİSTEMİ BOZUKLUKLARI”. Gazi Sağlık Bilimleri Dergisi, vol. 6, no. 2, 2021, pp. 42-52, doi:10.52881/gsbdergi.873465.
Vancouver Altmış H, Güçlü Gündüz A. BAŞ AĞRILI BİREYLERDE SERVİKAL KAS İSKELET SİSTEMİ BOZUKLUKLARI. Gazi sağlık bilim. derg. 2021;6(2):42-5.